THE HEALTH status of blacks, other minorities, and the poor remains unconscionably low when contrasted with that of white Americans. This disparity is not new but is an historical trend that can be seen across all categories of the leading causes of death and disease. In August 1985, the Report of the Secretary's Task Force on Black and Minority Health2 noted that minorities experienced approximately 60 000 "excess deaths" annually. Margaret Heckler, who was then the secretary of the US Department of Health and Human Services, emphasized that the disparity is "an affront both to our ideals and to the ongoing genius of American Medicine." The six major contributors to the disparity between black and white death rates are cancer, cardiovascular disease and stroke, diabetes, chemical dependency, homicide and accidents, and infant mortality. Since the 1985 report, blacks and Latinos, in particular, also have evidenced a disproportionately high rate